INTRODUCTION: The primary aim of this study was to examine the role of patient characteristics in predicting response to treatment in a sample of HIV-positive patients receiving 12 weekly sessions of a CBT-based pain management protocol. METHOD: A pre/post test single group design was used. Pain-related functioning was assessed at baseline and 12 weeks post-treatment using the Pain Outcomes Questionnaire-VA. DATA ANALYSIS AND RESULTS: Multivariate regression analysis showed that higher baseline levels of pain-related anxiety were related to greater improvement in pain-related functioning at post-treatment, and non-Caucasian participants reported a greater response to treatment when compared to Caucasian participants. Attendance to CBT treatment sessions focused on progressive muscle relaxation and cognitive reconceptualization of pain were also related to treatment outcome. CONCLUSION: Non-Caucasian patients reporting higher levels of pain-related anxiety may respond particularly well to treatment. Treatment sessions focused on progressive muscle relaxation and cognitive reconceptualization of pain may be particularly helpful.

J Behav Med. 2009 Aug;32(4):340-8. Cucciare MA, Sorrell JT, Trafton JA. Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (152), Menlo Park, CA 94025, USA. cucciare@hotmail.com

by Bernie Siegel, MD

As doctors we are not trained to communicate and understand the power of our words as they relate to a patient's ability and desire to survive. It is also not only doctors but all the authority figures in our patient's lives that affect their ability to survive and the outcome of their disease. Parents, teachers, clergy and physicians change lives with their words. It is hypnotic for a child or patient to hear an authority figures words. As I am always sharing, wordswordswords can become swordswordswords and we can kill or cure with either words or swords.

Up to the age of six a child's brain wave pattern is similar to that of a hypnotized individual. To quote a woman, whose mother only gave her failure messages and dressed her in dark colors, and who as an adult has more trouble with her mother's words than she does with cancer. "My mother's words were eating away at me and maybe gave me cancer." We know from recent studies that loneliness affects the genes which control the immune system. So as doctors we need to ask the right questions and know what a patient has experienced and is experiencing in their lives. Can you imagine treating Christopher Reeve's wife for cancer without knowing her family history?

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